As part of their 10-year plan for the NHS, the government have announced a Review of Patient Safety, which was initially triggered by the Review of the Care Quality Commission completed by Dr Dash in September 2024. In March 2025, Dr Penelope Dash became the new Chair of NHS England.

According to a DHSC statement delivered to the House of Lords on 7th July by Baroness Merron, a reorganisation of the patient complaint landscape will provide substantial benefits. (pages 2/3)

These changes will improve quality, including safety, by making it clear where responsibility and accountability sits at all levels of the system, and making it easier for staff, patients and users to directly feed into the system to improve quality of care.

Of course, the voice of the patient and that of the whistleblower will be at the heart of the process.

Patient and staff voice should not be kept at arm’s length but be at the heart of everything the NHS does.

Don’t get too excited. It has been decided that many of the patient safety bodies, which have largely sprung up in response to previous NHS scandals, are to be incorporated under the watchful eye of the Department of Health and Social Care, or report directly to another government quango.

Dr Dash made nine recommendations, which have all been accepted by the government.

HSSIB – Health Services Safety Investigation Body began life in 2017 as the Healthcare Safety Investigation Branch (HSIB.) Keith Conradi was selected to bring into the NHS the successful ‘no fault’ investigation methods used in the Air Industry. It can be seen in the case of Baby Harry Richford that HSIB were the only organisation to carry out a thorough review and reveal the truth. Conradi constantly fought with NHS England bosses and the DHSC, who appeared to have their ‘priorities elsewhere’.

So, HSSIB reports to CQC, who report to DHSC, who do what exactly? There is no independence in this structure, with reports ending up on the perpetrator’s desk so that they can more easily control the narrative.

The Patient Safety Commissioner reports directly to the Medicines and Healthcare products Regulatory Agency (MHRA), which has approved the drugs that are reported to have caused harm. They, of course, will hold themselves to account.

Local Healthwatch, born from the 2012 Health and Social Care Act to strengthen the voice of the patient, will now report directly into a DHSC silo. Alongside The National Guardian, introduced after the Sir Robert Francis Freedom to Speak Up Report in 2016, to amplify the voice of concerned NHS staff.

PALS – the Patient Advice and Liaison Service, who are employed by individual NHS Trusts as the first point for patient complaints, were not part of this review. Neither was the PHSO – Parliamentary and Health Service Ombudsman, who acts as the ‘last resort’ when all other complaint avenues have been exhausted. Presumably, the government are not concerned about the function of these bodies, as no reform has been put forward. All they have done is put the middlemen under the direct control of the government, then told us that this will improve patient safety.

This government and previous governments have perfected the brass monkey response to bad news and this reform simply makes it easier for them to bury the evidence and silence the complaining voices.

PHSO deny evidence

I’ll just leave this here: Recent headline from Health Service Journal.